{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:23:01Z","timestamp":1783488181451,"version":"3.55.0"},"reference-count":29,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"11","license":[{"start":{"date-parts":[[2015,11,1]],"date-time":"2015-11-01T00:00:00Z","timestamp":1446336000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:p> Developmental dysplasia of the hip (DDH) should be diagnosed as early as possible to optimise treatment. The current United Kingdom recommendations for the selective screening of DDH include a clinical examination at birth and at six weeks. In Northern Ireland babies continue to have an assessment by a health visitor at four months of age. As we continue to see late presentations of DDH, beyond one year of age, we hypothesised that a proportion had missed an opportunity for earlier diagnosis. We expect those who presented to our service with Tonnis grade III or IV hips and decreased abduction would have had clinical signs at their earlier assessments. <\/jats:p><jats:p> We performed a retrospective review of all patients born in Northern Ireland between 2008 and 2010 who were diagnosed with DDH after their first birthday. There were 75 856 live births during the study period of whom 645 children were treated for DDH (8.5 per 1000). The minimum follow-up of our cohort from birth, to detect late presentation, was four years and six months. Of these, 32 children (33 hips) were diagnosed after their first birthday (0.42\u00a0per 1000). <\/jats:p><jats:p> With optimum application of our selective screening programme 21 (65.6%) of these children had the potential for an earlier diagnosis, which would have reduced the incidence of late diagnosis to 0.14 per 1000. As we saw a peak in diagnosis between three and five months our findings support the continuation of the four month health visitor check. Our study adds further information to the debate regarding selective versus universal screening. <\/jats:p><jats:p> Cite this article: Bone Joint J 2015;97-B:1572\u20136. <\/jats:p>","DOI":"10.1302\/0301-620x.97b11.35286","type":"journal-article","created":{"date-parts":[[2015,11,3]],"date-time":"2015-11-03T12:21:22Z","timestamp":1446553282000},"page":"1572-1576","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":30,"title":["Delayed diagnosis of developmental dysplasia of the hip in Northern Ireland"],"prefix":"10.1302","volume":"97-B","author":[{"given":"K. J.","family":"Donnelly","sequence":"first","affiliation":[{"name":"Musgrave Park Hospital, Stockman\u2019s\rLane, Belfast, Northern\rIreland BT9 7JB, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. W.","family":"Chan","sequence":"additional","affiliation":[{"name":"Musgrave Park Hospital, Stockman\u2019s\rLane, Belfast, Northern\rIreland BT9 7JB, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. P.","family":"Cosgrove","sequence":"additional","affiliation":[{"name":"Musgrave Park Hospital, Stockman\u2019s\rLane, Belfast, Northern\rIreland BT9 7JB, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"r1","doi-asserted-by":"publisher","DOI":"10.5402\/2011\/238607"},{"key":"r2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.54B1.13"},{"key":"r3","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-014-1133-0"},{"key":"r4","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e3182745456"},{"key":"r5","doi-asserted-by":"publisher","DOI":"10.1136\/fn.76.2.F94"},{"key":"r6","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199309000-00008"},{"key":"r7","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.95B6.31461"},{"key":"r8","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7344.1031"},{"key":"r9","unstructured":"No authors listed. Newborn and Infant Physical Examination Group (NIPE). National Screening Committee Newborn and Infant Physical Examination Standards and Competencies, 2008. http:\/\/newbornphysical.screening.nhs.uk\/publications (date last accessed 10 July 2015)."},{"key":"r10","unstructured":"No authors listed. Department of Health: Healthy child programme: pregnancy and the first five years of life, 2009. https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/167998\/Health_Child_Programme.pdf (date last accessed 10 July 2015)."},{"key":"r11","first-page":"129","volume":"45","author":"Ortolani M","year":"1937","journal-title":"Pediatria (Napoli)"},{"key":"r12","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.44B2.292"},{"key":"r13","doi-asserted-by":"publisher","DOI":"10.3109\/17453679108999228"},{"key":"r14","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.76B4.8027129"},{"key":"r15","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.72B6.2246288"},{"key":"r16","doi-asserted-by":"publisher","DOI":"10.1097\/01202412-199302020-00003"},{"key":"r17","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.84B6.0840878"},{"key":"r18","doi-asserted-by":"crossref","unstructured":"Hall DMB, Elliman D. Health for All Children. Revised Fourth Edition. 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Northern Ireland Statistics and Research Agency: Live Births 1887-2012. http:\/\/www.nisra.gov.uk\/demography\/default.asp8.htm (date last accessed 10 July 2015)."},{"key":"r26","doi-asserted-by":"publisher","DOI":"10.1007\/BF00450934"},{"key":"r27","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2011-301085"},{"key":"r28","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197507000-00015"},{"key":"r29","first-page":"47","volume":"94","author":"Rosendahl K","year":"1994","journal-title":"Pediatrics"}],"container-title":["The Bone &amp; Joint Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.97B11.35286","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/full-xml\/10.1302\/0301-620X.97B11.35286","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.97B11.35286","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T04:59:36Z","timestamp":1634619576000},"score":1,"resource":{"primary":{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/10.1302\/0301-620X.97B11.35286"}},"subtitle":["can we do better?"],"short-title":[],"issued":{"date-parts":[[2015,11]]},"references-count":29,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1302\/0301-620X.97B11.35286"],"URL":"https:\/\/doi.org\/10.1302\/0301-620x.97b11.35286","relation":{},"ISSN":["2049-4394","2049-4408"],"issn-type":[{"value":"2049-4394","type":"print"},{"value":"2049-4408","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11]]},"assertion":[{"value":"2014-12-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-07-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-11-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}